Ashmita Thapa Ph.D., RN (Post-doctoral Research Associate) , Geunyeong Cha Ph.D., RN (Post-doctoral Research Associate) , Jia-Rong Wu Ph.D., RN, FAHA, FAAN (Professor) , Martha J. Biddle Ph.D., RN, APRN, CCNS, FAHA (Professor) , Abigail Latimer PhD, MSW, LCSW, APHSW-C (Assistant Professor) , Mark B Dignan PhD, MPH (Professor) , Chin-Yen Lin Ph.D., RN (Assistant Professor) , JungHee Kang Ph.D., RN (Assistant professor) , Debra K. Moser PhD, RN, FAHA, FAAN (Professor)
{"title":"农村冠心病和心力衰竭患者健康和抑郁症状的社会决定因素与生活质量的关系","authors":"Ashmita Thapa Ph.D., RN (Post-doctoral Research Associate) , Geunyeong Cha Ph.D., RN (Post-doctoral Research Associate) , Jia-Rong Wu Ph.D., RN, FAHA, FAAN (Professor) , Martha J. Biddle Ph.D., RN, APRN, CCNS, FAHA (Professor) , Abigail Latimer PhD, MSW, LCSW, APHSW-C (Assistant Professor) , Mark B Dignan PhD, MPH (Professor) , Chin-Yen Lin Ph.D., RN (Assistant Professor) , JungHee Kang Ph.D., RN (Assistant professor) , Debra K. Moser PhD, RN, FAHA, FAAN (Professor)","doi":"10.1016/j.hrtlng.2025.09.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>There are significant health disparities among rural populations, especially in the prevalence and management of coronary heart disease and heart failure. Social determinants of health (SDOH) play a crucial role in these disparities, influencing access to care, mental health, and overall quality of life (QOL). Depressive symptoms, common among rural patients with coronary heart disease and heart failure, may further exacerbate these challenges by mediating the relationship between SDOH and QOL.</div></div><div><h3>Objectives</h3><div>We aimed to examine the association between SDOH and QOL among rural patients with coronary heart disease and heart failure, as well as to determine whether depressive symptoms mediate this relationship.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis (<em>N</em> = 124) was conducted using data from a randomized controlled trial. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences questionnaire was used to measure SDOH, depressive symptoms were assessed using the Patient Health Questionnaire-9, and QOL was evaluated using Short Form-12. We performed hierarchical multiple regression and mediation analyses.</div></div><div><h3>Results</h3><div>Higher SDOH risk scores were significantly associated with lower QOL (<em>B</em>= -0.319; <em>p</em> < 0.001). Depressive symptoms mediated this relationship (indirect effect: a*<em>b</em> = -0.624, 95 % confidence interval (CI)= [-1.045, -0.273]), suggesting that individuals with higher SDOH risk had worse depressive symptoms, which in turn led to lower QOL.</div></div><div><h3>Conclusion</h3><div>The SDOH were associated with QOL in rural patients with coronary heart disease and heart failure, and depressive symptoms mediated this relationship. Findings highlight the need for targeted interventions addressing both social determinants and mental health to improve QOL.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"75 ","pages":"Pages 58-64"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The association of social determinants of health and depressive symptoms with quality of life among rural patients with coronary heart disease and heart failure\",\"authors\":\"Ashmita Thapa Ph.D., RN (Post-doctoral Research Associate) , Geunyeong Cha Ph.D., RN (Post-doctoral Research Associate) , Jia-Rong Wu Ph.D., RN, FAHA, FAAN (Professor) , Martha J. Biddle Ph.D., RN, APRN, CCNS, FAHA (Professor) , Abigail Latimer PhD, MSW, LCSW, APHSW-C (Assistant Professor) , Mark B Dignan PhD, MPH (Professor) , Chin-Yen Lin Ph.D., RN (Assistant Professor) , JungHee Kang Ph.D., RN (Assistant professor) , Debra K. Moser PhD, RN, FAHA, FAAN (Professor)\",\"doi\":\"10.1016/j.hrtlng.2025.09.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>There are significant health disparities among rural populations, especially in the prevalence and management of coronary heart disease and heart failure. Social determinants of health (SDOH) play a crucial role in these disparities, influencing access to care, mental health, and overall quality of life (QOL). Depressive symptoms, common among rural patients with coronary heart disease and heart failure, may further exacerbate these challenges by mediating the relationship between SDOH and QOL.</div></div><div><h3>Objectives</h3><div>We aimed to examine the association between SDOH and QOL among rural patients with coronary heart disease and heart failure, as well as to determine whether depressive symptoms mediate this relationship.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis (<em>N</em> = 124) was conducted using data from a randomized controlled trial. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences questionnaire was used to measure SDOH, depressive symptoms were assessed using the Patient Health Questionnaire-9, and QOL was evaluated using Short Form-12. We performed hierarchical multiple regression and mediation analyses.</div></div><div><h3>Results</h3><div>Higher SDOH risk scores were significantly associated with lower QOL (<em>B</em>= -0.319; <em>p</em> < 0.001). Depressive symptoms mediated this relationship (indirect effect: a*<em>b</em> = -0.624, 95 % confidence interval (CI)= [-1.045, -0.273]), suggesting that individuals with higher SDOH risk had worse depressive symptoms, which in turn led to lower QOL.</div></div><div><h3>Conclusion</h3><div>The SDOH were associated with QOL in rural patients with coronary heart disease and heart failure, and depressive symptoms mediated this relationship. Findings highlight the need for targeted interventions addressing both social determinants and mental health to improve QOL.</div></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":\"75 \",\"pages\":\"Pages 58-64\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956325001888\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956325001888","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
The association of social determinants of health and depressive symptoms with quality of life among rural patients with coronary heart disease and heart failure
Background
There are significant health disparities among rural populations, especially in the prevalence and management of coronary heart disease and heart failure. Social determinants of health (SDOH) play a crucial role in these disparities, influencing access to care, mental health, and overall quality of life (QOL). Depressive symptoms, common among rural patients with coronary heart disease and heart failure, may further exacerbate these challenges by mediating the relationship between SDOH and QOL.
Objectives
We aimed to examine the association between SDOH and QOL among rural patients with coronary heart disease and heart failure, as well as to determine whether depressive symptoms mediate this relationship.
Methods
A cross-sectional analysis (N = 124) was conducted using data from a randomized controlled trial. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences questionnaire was used to measure SDOH, depressive symptoms were assessed using the Patient Health Questionnaire-9, and QOL was evaluated using Short Form-12. We performed hierarchical multiple regression and mediation analyses.
Results
Higher SDOH risk scores were significantly associated with lower QOL (B= -0.319; p < 0.001). Depressive symptoms mediated this relationship (indirect effect: a*b = -0.624, 95 % confidence interval (CI)= [-1.045, -0.273]), suggesting that individuals with higher SDOH risk had worse depressive symptoms, which in turn led to lower QOL.
Conclusion
The SDOH were associated with QOL in rural patients with coronary heart disease and heart failure, and depressive symptoms mediated this relationship. Findings highlight the need for targeted interventions addressing both social determinants and mental health to improve QOL.
期刊介绍:
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.